| NPI | 1104158500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2012006926) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03108500) |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2012-11-02 |